This proposal is directed toward the development of permanent, significant changes in the curriculum of instruction in preventive pulmonary medicine at this Universtiy of Pittsburgh. The teaching of this topic is virtually non-existent at the institution at the current time. The proposed curriculum is a multi-disciplinary approach involving the School of Medicine, Departments of Medicine and Pediatrics, the Schools of Nursing and Public Health, and Western Psychiatric Institute. This proposal occurs at a particularly opportune time as the principal investigator will be able to exploit the multiple liaisons which he has developed during the application for and initiation of the NIH funded "Lung Health Study." The following methods of curriculum change will be utilized including increasing course content on preventive pulmonary medicine in PHysiology, the Introduction to Patient care elective, and the Introduction to Clinical Medicine Block; increasing conferences on appropriate topics in medical, nursing, and pediatrics rotations, and the development of a Learning Resources Center available to all health care personnel. The importance of the prevention of pulmonary disease wil be highlighted and continuously emphasized by the initiation of a Preventive Pulmonary Medicine Clinic which will serve as a focus not only for patient care, but also as a center for the development of patient education tools. Through the services of the Office of Evaluation of Teaching at the University of Pittsburgh and an internationally known Advisory Committee, the principal investigator is in a position to evaluate effectively changes in both the data base and behavior of individuals participating in the program in preventive pulmonary medicine. In addition to traditional methods of assessment, simulated patients will be utilized in three years of the medical school and the residency program to assess and quantify behavioral changes. In the later years of this proposal, computer generated patient simulations will be an integral part of this evaluation process. The research proposal presented represents an extension of the principal investigator's work in the Lung Health Study and is intended to evaluate the effectiveness of a physician message based heavily on the results of pulmonary function testing in inducing smoking cessation.